Provider Demographics
NPI:1568724995
Name:MILLER, CHRISTINA ZACCARIO (MSED)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ZACCARIO
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 E 84TH ST
Mailing Address - Street 2:APARTMENT 6A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6200
Mailing Address - Country:US
Mailing Address - Phone:212-987-2616
Mailing Address - Fax:
Practice Address - Street 1:434 E 84TH ST
Practice Address - Street 2:APARTMENT 6A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6200
Practice Address - Country:US
Practice Address - Phone:212-987-2616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist